In this episode, we learn about Senior Options with Clinical Manager Andrea See and Care Coordination Assistant Tara Hunter. We cover program funding, a typical day in the life of a senior options staff member and discuss challenges and successes in this case management program.
Let me know what you think of this podcast, as well as any ideas you have for an episode. Email me at kwhite@coaaa.org!
Copyright 2024 Central Ohio Area Agency On Aging
Welcome to Pretend I Know Nothing about I'm Katie White, your host administrator of COAAA. Okay. Today on Pretend I Know Nothing About, We are learning about Senior Options with clinical manager Andrea See and care coordination assistant Tara Hunter.
Speaker B [:Hello.
Tara Hunter [:Hi.
Katie White [:Welcome. Thanks for being here.
Tara Hunter [:Thank you.
Katie White [:Very official. Okay, so we are going to start off with Andrea. So give us a little introduction about yourself, your role, and your program.
Andrea See [:Sure. So I am Andrea C. I am the clinical manager of senior Options here at Coaaa. I have been in this position for almost nine years, which is wild to me. Senior Options is a levy funded program that provides case management services and in home assessments for Franklin County residents who are needing some additional help to stay at home. So I am overseeing that department.
Katie White [:Great. How many people are in the department?
Andrea See [:About 50 right now.
Katie White [:Okay.
Andrea See [:And always looking for new ones.
Katie White [:Always. Except not stealing from other departments.
Andrea See [:No, never. If you have friends or relatives that do not work at COA and are interested, send them my way.
Katie White [:Yes. Okay. Let's stick with you for a second. So tell us about your career path. What other places have you worked? What have you done?
Andrea See [:Sure. So, I have always been interested in older adults. I actually wrote my entrance exam essay to Ohio State saying that I wanted to work at an area agency on Aging and help people stay at home and in the community. Wow. So was on that older adult path from the beginning. Worked at the Alzheimer's Association for a period of time, then moved over to COA, was a passport case manager for about three years, and then I went up to Union County and helped sort of build out their levy program. And I was there for about three years, and then I came back as a passport supervisor and then moved into this position shortly after that.
Katie White [:See, I didn't even know you worked in Passport. This is the magic of a podcast.
Andrea See [:Yeah. So older adults is my thing. Took care of my grandma, who had Alzheimer's disease. I think a lot of us have grandma stories and just had a hard time navigating the system. And so when I was thinking about what am I going to do with my life, I was like, this is where I want to be. My parents were both social workers, so I knew what that looked like, but knew that I wasn't looking for the same track that they were in. So here I am.
Katie White [:I love it. Okay, Tara, you're up.
Tara Hunter [:Yeah. I'm the care coordination assistant for senior options. I've been here right around three years.
Andrea See [:She's a pandemic baby.
Tara Hunter [:I am. Yeah. So I had a mutual friend who was a case manager, and she said, I need your resume right now. I said, okay, right in the pandemic, and the rest is history.
Katie White [:Great. And did you work anyplace before you got here?
Tara Hunter [:I did. When I stayed at home with my kids, I decided to go to college because I always wanted to be a social worker.
Speaker B [:Great.
Tara Hunter [:I wanted to work with kids until I had kids. So I started out in sign language, wanted to be an interpreter, and then changed it when I got an internship at Goodwill. So I started out as a Floater, which is kind of like a sub for their day program in their Sage program, which was older adults, 45 and older.
Katie White [:Okay.
Tara Hunter [:And I loved it that's when they had the jobs, they helped people. They worked in the program, sorting clothes, different things like that. And then I actually took a job in the young adult program, first off as a service coordinator and then as the program manager. And then once the pandemic hit, and then everybody had to stay home and things were up in the air.
Katie White [:Okay, well, their loss is our gain.
Tara Hunter [:Exactly.
Katie White [:Good. I love it.
Tara Hunter [:Yeah.
Katie White [:So give us an overview of senior options. As you know, this podcast is for staff that are new or staff that have been here but don't know anything about senior options. So how does it work? Who do you serve? Give us the whole spiel.
Tara Hunter [:Well, my role is a little bit different than the case managers. I say I get to do the fun part of it.
Katie White [:Okay.
Tara Hunter [:As far as coming in, doing all the little things, like helping with the food stamps, helping with the heap, assistance, doing deliveries, things like that. I help with a furniture bank, scheduling with that. I go to some of the buildings once a month and kind of help with them some extra services. Okay. With, like, the food box delivery, food stamps, Medicaid, getting them on the Waiver program, just doing all the little stuff that's kind of overwhelming to them, but crucial. Very crucial. And they're very appreciative of it, too.
Katie White [:This is why I love people that work here, because it's like these applications and these processes are so hard, and it's what brings you joy.
Tara Hunter [:Amazing.
Katie White [:Yeah.
Tara Hunter [:It's really nice when they get this long list of documents that they need, and you just kind of walk them through them. It's not that bad. And then that big wave of relief you see wash over them. They're like, thank you.
Katie White [:Thank you. I love it. Yeah.
Andrea See [:Tara helped over 500 people receive benefits in the last year. Wow.
Katie White [:In one year.
Andrea See [:Yeah. You sort of tracked the statistics for the Office on Aging, and it was like 527 assistance with all of the things she mentioned. Right. So getting all of those documents for food stamps and medicaid and heap and pip and really having that direct impact with folks that are low income and not able to meet their basic needs without some assistance.
Katie White [:Particularly when so many things are online now. It's like not that older adults aren't interested in online and not that they're not online doing things, but these applications are so complicated and so overwhelming. And to have someone to be with you literally next to you, helping you step by step is a huge service.
Tara Hunter [:And then also too, gaining their trust with all their personal and sensitive information right. And just coaxing them through it. It's good.
Katie White [:I like it.
Tara Hunter [:I really like it.
Katie White [:Okay, so that's the senior option. CCA role. Tell us Andrea, about the care coordinators and then tell us about your role.
Andrea See [:Sure.
Katie White [:And the soups, too. Don't forget about soups.
Andrea See [:No, never forget about the soups. They're busy. Sometimes I think they have the hardest job of all of us. So we have about 50 staff. As I mentioned. Most of those are licensed social workers and nurses who are providing case management services for, like I said, Franklin County residents over the age of 60 who are just needing some additional help to stay at home. So that's really the only criteria to be on senior options. You just need to be wanting services and living in the county. The folks that we're case managing at Coaaa are typically folks who need some additional support. So they're needing face to face case management support. They're needing more contact than like, a telephone case manager would be able to provide. Okay, and I'm skipping ahead a little bit, but the levy is designed to help people who area not eligible for Medicaid waiver services. And so they don't necessarily have to have Medicaid. They don't need to be meeting that intermediate level of care or need that hands on assistance in order to access our services. And so we partner with the Franklin County Office on Aging to provide that assessment piece and then these in home case management services for them. So somebody calls in on the county telephone number. They say that they're interested in senior options. That referral comes over to us. We do an initial home visit. We identify what their needs are, we talk to them about what they're interested in, and then they're either case managed by us, or they go back over to the Office on Aging for telephone case management. Okay, so I'm overseeing that. And all of the exciting things that happen week to week, I don't think that any day is the same at COA. It doesn't matter what position you're in. We have lots of staff going out and seeing lots of people. I think my role is mostly just relationship building with the county, trying to figure out policy issues or concerns, trying to identify issues that are happening in the field and making the program work as well as it can for as long as it can.
Katie White [:Yeah. And so for those listening, some of the case management and contracts that we work on automatically go through an area Agency on Aging. The Franklin County Office on Aging or Senior options. Grant is something we earn. We apply for, it's not automatically given to us. And so I think it's a real testament to you and your team how long we've had this grant. And through different directors, we've kept the grant and how the program is kind of going through some changes right now to meet the new and emerging trends and challenges. So I just really want to raise that up because this is not a guaranteed contract that we have, and we work hard for it, and that's why we get to keep this grant year over year.
Andrea See [:Yeah, and we've been in place I mean, we've been contracting with the Office on Aging since the very, very beginning of this levy. And it's a successful levy. We're always passing in that high 70% voter turnout rate. So I like to explain it almost exactly how you did when we have new staff that are coming on and saying, what's the funding source? Kind of concerned about their jobs. And I say there is no guarantees. And yet we have been doing this work for over 30 years. And our relationship with the Office on Aging is good. It is. We are going through changes in leadership and just how do we serve the number of people who have needs right now? But to me, that's the exciting stuff. That's the stuff where we get to problem solve. It's the place where we get to be creative about care and service and what are the needs in the community.
Katie White [:Yeah, I agree. Okay. Every day is different, for sure, but sort of like, in general, give us an idea of what goes on. Maybe not on a day to day basis, but like a week to week basis. Like, referrals come in, we go out. Give us the central idea.
Tara Hunter [:A general day for me would be coming in, following up on emails, requests that are coming in. I work very closely with Mary, shout out to Mary, who keeps everything going. She can check the systems. Gives me a general idea to follow up with from then I'll go through, make my phone calls, make my initial contact with the clients, introducing myself. This is what I'm trying to help you with. This is what we need. Sometimes they have it, sometimes they don't. Give them a little bit of time and then just kind of start scheduling home visits here and there, following through, walking up with them, then getting it back, getting everything printed off and in order so I can give it back. So do you submit it?
Katie White [:Do you work with a certain team of case managers or you support all of 50 case managers. Okay, so that's a lot.
Tara Hunter [:It is.
Katie White [:So they can come to you if it's a busy week or whatever, or if it's specific tasks and then you're helping to make sure that those get done. Okay. Got it.
Andrea See [:Digging through piles of paper piles.
Katie White [:Yes.
Andrea See [:Looking for verifications where's the most recent bank statement, that sort of thing.
Katie White [:Yeah, it's a lot.
Tara Hunter [:It is a lot, yeah.
Katie White [:Okay, so then the case managers, you mentioned that you get the referrals, so there's an assessment.
Andrea See [:So case managers are getting about two new, what we call new screens or new initial assessments assigned a week. And then they have a caseload between 50 and 60, 55 that they are then seeing on a regular schedule based on those folks at Acuity. Okay, so they're busy. I mean, they're out most of the time. I want them out. I want that's where they're doing their best work, is just meeting people in their homes and seeing what their needs are. They all schedule sort of their days, I think, differently. And so some of them are coming in in the morning, getting their paperwork together, figuring out their day, and then heading out for the afternoon. Some folks are the opposite, right? They're leaving from home, going out, doing those visits, and then coming in afterwards and dropping paper off or kind of tidying up, making phone calls to the folks that they can't reach, that sort of thing.
Katie White [:So then tell us about the soups. What are the supervisors doing?
Andrea See [:The supervisors are doing a lot of chart review right now. I'm trying to say, like, let's shift this a little bit, guys, but they do quite a bit of chart review. And just like oversight, they're handling the complex clinical cases that are coming. So trying to give some direction around this person's about to be evicted or this person doesn't have any utilities. What can we do about that? Pushing that up to me. Taking it to Safe, those sorts of things. They're also doing risk assessments if we have some concerns in the community. Going out and doing joint visits with a case manager to provide support.
Katie White [:Okay. And then of course, four month reviews, eight month reviews, annual reviews, all of those funds. Supervisors things. Yes. Supervision.
Andrea See [:Supervision. Monthly team meetings. Monthly supervisor team. My team meets weekly and then I meet with each of them monthly. So there's lots of meetings. I always say meetings are sort of my job. I'm in a lot of meetings.
Katie White [:There are a lot of meetings. I'm trying to think what else for the supervisor role. Just if you're thinking about this, there's probably a lot in Day Force and Timesheets, it's a lot of oversight and just sort of making sure that we are doing everything that the central says.
Tara Hunter [:We need to do.
Andrea See [:Yeah, it's a lot of checks. It's a lot of checks. Making sure that things are going the way that they need to be.
Katie White [:Okay, so then when we think about your role as clinical manager, in addition to maintaining the contract and the relationships and all of the political tightrope walking that goes along with that, what else area you doing on a usual weekly basis?
Andrea See [:I'm mostly checking in with supervisors to make sure that things are going as smoothly as they can. Right. So is there a policy that we're bumping up against that we need to advocate for? Is there something that we need to build out? Is there something that we need to kind of sort out? I'm doing a fair bit of interviewing right now and trying to just build out programmatically what the future is going to look like for the program. So we've been operating very similarly for a long time. And we're in a place right now where I think that things are changing. Services that we can provide in the home are changing, the amount of folks that are needing services is changing, the acuity level of the folks that are needing help is changing. And so how are we able to really provide the needs, support the support folks in the community as best we can with the with the support and services we can provide? Yeah, so that's all like real big, high level stuff. But in the day to day, it's like, well, can we get another person to do these tasks that will free up this person to do these other tasks and sort of looking at the program as a whole and seeing what might be successful and then trying it.
Katie White [:Yeah. And I know we have a lot of conversations around supporting all staff members. So whether it's caseloads or office equipment or office space, there's a lot of conversations that go on around what do staff need, what we provide, what's the balance between what our budget has and what we know the needs are, and how can we shift that around? And so, of course, appreciate all those conversations as well because it's not easy to make all these decisions. I have a magic eight ball in here because I have decision fatigue. I just shake that baby up, see what it says.
Andrea See [:It really comes out in the evenings where I'm like, I can't decide anything.
Katie White [:What's for dinner?
Andrea See [:No, I can't decide no more chicken nuggets every night. Chicken nuggets every night.
Katie White [:Veggie nuggets in my house. Sylvia's vegetarian. Okay, so biggest challenge. What's one of your biggest challenges? It can be literally whatever you want. Doesn't have to be case management related. It does have to be work related.
Tara Hunter [:I think, though, I think one of the biggest challenges for me is a lot of these calls or clients that I'm working with. I'm going in blindly.
Katie White [:And in that.
Tara Hunter [:Initial call, just kind of feeling out where they are, empowering them to know to get the things that they need. But then again, also, if I've got a client who says, I'm bedridden, I can't walk, I don't know this finding those different avenues to get what they need. So you want to be able to empower them to do things for themselves with as much help as we're giving them and then also being that extra set of hands for a different client.
Katie White [:Yeah. And knowing that a lot of the resources that we used to have plenty of are either diminishing or gone or look really different and just kind of constantly being up on that housing.
Tara Hunter [:Are we?
Katie White [:We can get there.
Andrea See [:It is like making a mental list of right.
Tara Hunter [:Exactly.
Katie White [:Only one challenge. I only share one challenge.
Andrea See [:Making sure everybody's timesheets. Right.
Katie White [:Right.
Andrea See [:And then no. Tara needs some reminders about her timesheet.
Katie White [:I'm still getting used to the timesheet, to be honest. I'm like, I haven't had a time. We have paper timesheets. I haven't had a timesheet ever in my whole life. And every other Thursday on my calendar, dings. I'm like, oh, my timesheet.
Andrea See [:Yeah, timesheets too. They got to put in their lunch and the thing, and there's a lot of little boxes to fill.
Tara Hunter [:Boxes.
Katie White [:Okay, I need to look at one of those. I haven't seen one. All right, what's your challenge, Andrea?
Andrea See [:I would say some of the things that Tara has touched on, I think the challenges that we see, that I see, I guess my two biggest challenges, or at least the things that keep me up at night, is staff safety. So making sure that folks are remaining safe out in the community, making sure we're doing what we need to be doing, per our contract, per the expectations of our funder, and also making sure that we're keeping people as safe as possible. I feel like the climate has changed out there a fair bit, and we're just seeing people that are really living pretty marginally in lots of different ways. And so making sure that my staff is safe and feeling comfortable going out there every day is huge for me. The other piece, I think that is both of these are staff related, but I have a lot of empathy for folks that are not able to receive services because of the worker shortage and the individuals that we're serving. But I also have a lot of empathy for our case managers who are used to being able to have a toolbox of these things that they're able to provide to help people remain safe in their homes. And that toolbox is less right. It's not empty, but there's fewer things, like you said, that we can offer. And the moral distress that comes along with that with staff that are seeing folks and thinking, two years ago, I could have helped this person in a very specific way. And now I know I'm not going to be able to find a provider or an adult day or whatever it may be to help them remain safe at home.
Katie White [:Yeah, I would totally agree with that. I worry about that so much. And Erica Drury, who's clinical programs manager, director, client services. Client services. I still don't have the titles or the classifications down, to be honest. But anyway, she has a really good reframe around that that I find encouraging, which is that staff need to really value how much of an intervention and a resource and a tool that we are or you all are.
Tara Hunter [:Right.
Katie White [:And even though there is a lot of moral distress that comes with not being able to connect to more resources, we still are this crucial point and there for individuals and someone that they can call, and that is a value. It might not feel as gratifying as it used to, but just to make sure we don't lose sight of that.
Andrea See [:Absolutely. We actually received a voicemail this morning.
Speaker B [: eiving support services since: Andrea See [:It was nice to hear that. Thank you.
Katie White [:Okay, we've got a little bit of time left, so I want to make sure I hear about what's one of your favorite stories, but then to make sure that you can talk about what you want to talk about. If you were in charge for the day, what's, like, one thing you would do to make COA better? So success story and then miracle question.
Tara Hunter [:I think it's pretty great. Right now, I can't think of anything.
Andrea See [:Massage chairs.
Tara Hunter [:I got to think out of the side of the box on this.
Andrea See [:Community garden.
Tara Hunter [:Community garden.
Andrea See [:For those of you listening, if you are interested in helping find funding, white a proposal. Dig in the dirt for community garden in the parking lot. Call me.
Katie White [:That's area.
Andrea See [:That's my plug, not Katie.
Katie White [:Andrea. Yeah, let her inbox. Community guarding, meaning we're eating the food. Community gardening, meaning it's for the raccoons.
Tara Hunter [:That live nearby, for the people.
Katie White [:Okay, everyone, community.
Andrea See [:So my vision, my idea of this is that we have a small plot on the south side of the parking lot, far enough away from the roof that we don't have critters having a snack and then climbing into our building.
Katie White [:But that has happened recently, within the.
Andrea See [:Last month that we partner with reckon parks and see if they can help us dig in the dirt a little bit. And then it can be therapeutic for staff. It could be food if there's people walking walking through the parking lot, food for me if I forget my lunch or the raccoons eat it all. And we're just in the business of having our hands in the dirt for a little while after a stressful call or day.
Katie White [:Got it. I like it. I don't know if Phil or John or Rick for that matter, will ever listen to the podcast, but if they were listening right now, can't you see them being, like, a garden? No way. And there's, like, a list already forming in their head of reasons why not.
Andrea See [:So my other idea is the cat sanctuary in the courtyard. And so I think if I lead with the cat sanctuary and then go into the community garden, I have a better chance.
Katie White [:Yes. Cat sanctuary in the courtyard.
Andrea See [:Just a couple. It's better than the generator.
Tara Hunter [:Yes.
Katie White [:Just in case nobody ever or you're listening and you weren't here for this. We recently had a raccoon in the courtyard, and honestly, it was great fun to go watch and see me taking, like, the best naps of his life. His paws were so cute. Yeah, it was a whole thing.
Tara Hunter [:I like the science posted on the doors. Don't open the door.
Andrea See [:15 sides.
Katie White [:15 sides.
Andrea See [:Classic COA.
Tara Hunter [:So good.
Andrea See [:One side not enough.
Katie White [:It was so good. Do not enter. Do not open this door. There's a raccoon. And then the one day, there was, like, a bunch of little things all around the door, and I was like, oh, my God, did the raccoon get.
Andrea See [:In, like, tear up his own sign? Come join me.
Katie White [:That's what it looked like. Don't keep the door shut. Open the door. Okay, so final thoughts. What do you want people to know about senior options? What's the heart and soul of it? It can be in the form of a story. It can be in the form of the fact that your office space is the best or whatever you want.
Tara Hunter [: with each other from the past: Katie White [:So the sense of family is unique to the senior options group. Yeah. And we do case manage people and senior options potentially much longer than other contracts, right?
Andrea See [:It seems that way, and I don't know if that's I think maybe it's just because folks are healthier, right. They're not meeting that nursing home level of care. But, yeah, we have folks that will be on the program for, like, 10, 12, 15 years, and they'll have the same case manager. Wow, that's incredible.
Katie White [:I did that home visit with Camille, and that was the case. The whole family knew her, and they were so excited. And there was the client, and then the client's brother and the client's daughter and the grandson, and everybody loved Camille. She went and sat on the couch and they were, like, right next to her showing pictures on the phone. It was great. And I think she said she had been with them for over ten years. I want to say even longer, though.
Andrea See [:Yeah. We have long term employees that have just been the heart and soul, I think, of options because we're not bound by Medicaid contracts. We're able to be more creative about how we're supporting and taking care of folks and getting them what they need. And that piece is the part that is so exciting to me. I think we had a case manager who was working with somebody who had overstayed a worker visa, and so he's not documented and is not eligible for really a whole lot of support. And she was able to connect him with an immigration attorney with, I think, Capitol University, and just making sure that he's able to kind of get as many of his needs met as possible. Just working tirelessly for him in all of these ways. That is not service connected. Right. It's like she saw the whole picture of him and was able to say, okay, this is what you actually need. Yeah, you need meals because you can't afford them, but also you need this kind of support.
Tara Hunter [:A lot of personalization that's where all the case managers go. Yeah. I'm really proud to be a part of it. I really am.
Katie White [:Good.
Andrea See [:And also, we have really good potlucks. Just saying.
Katie White [:Haven't received an invite, but that's fine.
Andrea See [:Terry O'Connor's retirement party is coming. I don't know when this podcast is being released, but isn't it at a bar? May 25. It's in the education room first and then happy hour later. Okay, look at the invite.
Katie White [:Also, again, not good at emails. Well, thank you both so much. This was so much fun. And what a better place to start than with you two for our first staff podcast.
Andrea See [:Happy to be here anytime, anytime.
Katie White [:Thanks. Well, thank you to Andrea and Tara. What a great episode. It if you liked what you heard and you're interested in sharing about what you do, send me an email. I promise I'll read it. Even though I said I didn't read my emails, I do try, and hopefully now you know something about Senior Options. Thanks for listening.